Counterbalancing the Hydroxychloroquine Induced QT Prolongation: COVID
19 and Beyond
Abstract
Those patients with progressive QT prolongation or QT interval exceeding
>500 ms may complete the COVID 19 treatment protocol
containing HCQ and/or AZM without serious arrhythmias and torsades de
pointes by the adding the mexiletine or lidocaine as an adjunctive drug
in those patients. Counterbalancing the QT prolongation by mexiletine in
association with would further decrease the labor and stress of
healthcare providers during the continuing COVID 19 pandemic. Although
it is a big dilemma how the therapeutic or prophylactic use of HCQ will
end up, the pathophysiologic effects of HCQ on QT interval and
counterbalancing by antiarryhthmic drugs mexiletine and lidocaine is out
of the current discussion of COVID 19 pandemics. Counter balancing
effect of mexiletine and lidocaine on QT interval in patients receiving
HCQ would be helpful in patients with not only COVID 19 but also in
malaria and rheumatologic disease as well.